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Stop Herceptin because of heart problems?

Page last modified on: August 1, 2008
Question from MsM: My oncologist recently stopped my Herceptin treatment. My heart is only functioning at 45 percent after starting treatment and I have an artificial aortic heart valve. They knew this when I began chemo treatment. Some clots have been found in my lungs. My oncologist said he would see me in 3 months. I'm concerned and confused and I wondered what you would suggest I do?
Answer —Larry Norton, M.D.: Obviously I can't give specific advice, not knowing your case in-depth. However, there are a few points to be made here. First, valvular heart disease is not a contraindication for Herceptin (chemical name: trastuzumab), and having valvular heart disease does not increase the risk of developing heart toxicity from Herceptin. However, if there is weakening of the heart muscle from Herceptin, it is totally appropriate to stop the Herceptin. Often in that setting, doctors give medication to strengthen the heart. When those medications are successful, it is sometimes proper to restart the Herceptin. Only an expert medical oncologist could properly handle this situation. The other thing to note is that Herceptin lasts in the bloodstream for a long time after it's stopped. The reason for the 3 month period is that the Herceptin is actually still working against the cancer in that period, even though it is not being administered. The issue of blood clots in the lungs is a separate issue, probably related more to the valves than the Herceptin. Most people with blood clots are given anti-clotting medications to allow those clots to dissolve and to prevent new clots from forming. If any individual is not totally comfortable with an opinion they've received from any doctor, it is acceptable to seek other medical advice for clarification and sometimes a fresh opinion. In other words, a second opinion in this case might be in order, even if the second opinion did turn out to agree completely with the first opinion.

On Wednesday, October 17, 2007 our Ask-the-Expert Online Conference was called Living with Metastatic Breast Cancer. Larry Norton, M.D. and moderator Marisa Weiss, M.D. answered your questions about managing day-to-day life with metastatic breast cancer.

The materials presented in these conferences do not necessarily reflect the views of breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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Larry Norton, M.D.Larry Norton, M.D. is deputy physician-in-chief and director of Breast Cancer Programs at Memorial Sloan-Kettering Cancer Center in New York City.

Marisa Weiss, M.D. is a radiation oncologist specializing in breast cancer and the founder, president, and guiding force behind Breastcancer.org.

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